评价C3肾小球病变的临床、实验室和治疗方式:单中心经验

Prilozi Pub Date : 2019-10-01 DOI:10.2478/prilozi-2019-0010
H. H. Yeter, Erdem Sütiçen, B. Korucu, Ö. Helvacı, Burak Özbaş, I. Gönül, Ülver Derici, T. Arınsoy, G. Güz
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引用次数: 1

摘要

背景/目的:C3肾小球病变(C3GP)是一种罕见的肾小球肾炎(GN),可导致终末期肾病(ESRD)。该疾病的组织病理学特征尚未明确,预后因素和最佳治疗方法尚不完全清楚。本研究的目的是确定C3GP患者的人口统计学、组织学变化、治疗方式和结局。材料和方法:本回顾性观察性研究于2013年至2017年在安卡拉加齐大学肾脏学系进行。所有肾活检符合C3GP标准的患者都被纳入研究。结果:24例C3GP患者(50%为男性,年龄在中年- 43岁)被纳入本研究。21%(5/24)的患者发展为ESRD。与未发生ESRD的患者相比,ESRD患者的肾活检结果(如新月形成、肾小球硬化和肾小管萎缩)相似。将患者的治疗方式分为MMF为主和非MMF为主两组。两组间eGFR保存差异无统计学意义。两组患者完全缓解的成功率相似。入院时血清肌酐水平>2.3 mg/dl和需要肾脏替代治疗(RRT)与肾脏生存降低相关。结论:MMF与非MMF治疗C3GP疗效相近。诊断时血清肌酐水平高于2.3 mg/dl和入院时需要RRT是ESRD的强预测因子,具有高敏感性和特异性。
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Evaluation of Clinical, Laboratory and Treatment Modalities in C3 Glomerulopathy: Single Center Experience
Abstract Background/aim: C3 glomerulopathy (C3GP) defines a rare group of glomerulonephritis (GN), which could lead to end stage renal disease (ESRD). Histopathologic features of the disease have yet to be defined and the prognostic factors and optimal treatment are not fully known. The purpose of this study was to determine the demographic, histological change, treatment modalities and outcomes among patients with C3GP. Material and method: This retrospective observational study was conducted in the Department of Nephrology, Gazi University, Ankara, from 2013 to 2017. All patients with kidney biopsies fulfilling the criteria for C3GP were included in the study. Results: Twenty-four patients with C3GP (50% male and of middle age - 43 years old) were enrolled in this study. 21% (5/24) patients developed ESRD. Renal biopsy findings such as crescent formation, glomerulo-sclerosis and tubular atrophy were similar in patients with ESRD, when compared to patients who did not develop ESRD. The treatment modalities of the patients were examined in two groups as MMF based and non-MMF based. The difference in the preservation of eGFR did not reach statistical significance between these two groups. The success rate of complete remission was similar between both groups. Serum creatinine levels >2.3 mg/dl at admission and need for renal replacement treatment (RRT) were associated with decreased renal survival. Conclusion: MMF based or non-MMF based treatments have similar efficacy in C3GP. Serum creatinine level higher than 2.3 mg/dl at the time of diagnosis and need for RRT during admission are a strong predictor of ESRD with high sensitivity and specificity.
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